Association of Periodontitis with Rheumatoid Arthritis and the Effect of Non-Surgical Periodontal Treatment on Disease Activity in Patients with Rheumatoid Arthritis

Xinyuan Zhao, Zhongjun Liu, Dalong Shu, Yanlin Xiong, Minzhao He, Shuaimei Xu, Shanhan Si, Bing Guo, Xinyuan Zhao, Zhongjun Liu, Dalong Shu, Yanlin Xiong, Minzhao He, Shuaimei Xu, Shanhan Si, Bing Guo

Abstract

BACKGROUND The association of periodontitis (PD) with the prevalence of rheumatoid arthritis (RA) remains controversial. Therefore, the aim of this study was to evaluate their correlation and investigate the effects of non-surgical periodontal treatment on RA. MATERIAL AND METHODS A total of 64 patients were enrolled in this study and divided into 4 groups: 18 PD patients (PD+RA-), 18 RA patients (PD-RA+), 18 RA with PD patients (PD+RA+), and 10 healthy controls (PD-RA-). Periodontal and rheumatologic parameters were examined at baseline and 1 month following non-surgical periodontal treatment. RESULTS Our results showed that RA patients had similar periodontal status. However, patients in the PD+RA+ group had significantly higher levels of rheumatologic parameters such as C-reactive protein (CRP), anti-cyclic citrulline peptide antibody (ACPA), erythrocyte sedimentation rate (ESR), and Disease Activity Score 28 (DAS28) than those in the PD-RA+ group. In addition, non-surgical periodontal treatment was efficacious in improving rheumatologic parameters of patients in the PD+RA+ group. CONCLUSIONS The presence of PD might contribute to the progression of RA, while RA might have little effect on accelerating the development of PD. In addition, RA patients with PD receiving non-surgical periodontal treatment resulted in noteworthy improvement in the clinical outcome for RA.

Conflict of interest statement

Conflict of Interest

None.

Figures

Figure 1
Figure 1
No significant difference was found in the periodontal parameters (PLI, GI, BOP%, and PD) at baseline between patients in the PD+RA+ and the PD+RA− group as well as patients in the PD−RA+ and the PD−RA− group (P>0.05).
Figure 2
Figure 2
The levels of DAS28, hsCRP, ESR, and ACAP were all significantly increased in the PD+RA+ group compared with the PD−RA+ group.
Figure 3
Figure 3
No significant difference was found in the periodontal parameters (PLI, GI, BOP%, and PD) at 1 month following treatment between patients in the PD+RA+ group and the PD+RA− group (P>0.05).
Figure 4
Figure 4
No significant difference regarding levels of DAS28, hsCRP, and ESR was observed between the PD+RA+ group and the PD+RA− group at 1 month following treatment (P>0.05). The serum level of ACAP was higher in the PD+RA+ group than in the PD+RA− group (P=0.032).
Figure 5
Figure 5
Following treatment, all the periodontal and rheumatologic parameters were all significantly downregulated in the PD+RA+ group (P<0.001).
Figure 6
Figure 6
Following treatment, all the periodontal parameters and serum ACAP levels were significantly reduced in the PD+RA− group (P<0.001).
Figure 7
Figure 7
(A–D) Spearman analysis was performed to evaluate the correlation between the changes in the periodontal and rheumatologic parameters following treatment.

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